About Vivek

I'm a recent college grad from Boston University in Chemistry and Classics. I created this blog to force me to write more often. Practice makes perfect :).

Personalized Medicine Conference

I recently attended the Conference on Personalized Medicine: Impacting Healthcare, hosted by Harvard Medical School, Partners Healthcare, and Harvard Business School two weeks ago. I’ve been reading a lot about personalized medicine in scientific journals lately, so I thought this would be a great conference to attend. I learned quite a bit, so I thought it might be useful to share some notes from my experience.

Personalized medicine is a model of medical care that emphasizes the use of information about an individual patient to guide clinical decisions regarding therapeutic or preventative care. The Personalized Medicine conference (hosted by the Harvard Medical School, Partners Healthcare’s Center for Personalized Genetic Medicine, and Harvard Business School) brought together high-profile experts on this topic from industry, government, academia, and healthcare. The conference gave a broad perspective on the progress, limitations, and outlook of personalized medicine in this country, as well as internationally. The head of the Center for Personalized Genetic Medicine, Raju Kucherlapati, says that personalized medicine is in a Dickens-ian “best of times and worst of times” because in spite of great progress, it is still over-promised and under-delivered.

According to Dr. Mark Boguski (Harvard Medical School), 70% of clinical decisions are based on lab tests, either from molecular diagnostics, pathology, or radiology. Because of progress in personalized medicine, he thinks this percentage will continue to increase each year. As an example of progress, Harvard’s Laboratory for Molecular Medicine has added 10 new genetic tests this year (see their page for lists of available genetic tests and their prices).

Progress has also been made in the pharmaceutical industry, as the industry leaders are moving away from the “blockbuster drug” research model in which only drugs that can be prescribed to large populations are developed since they are the most financially rewarding projects. Mikael Dolston, president of worldwide research and development at Pfizer, says his company is moving towards a “precision medicine” drug development model. Precision medicine is an approach that lies somewhere between the personalized medicine and blockbuster drug development methodologies. Precision medicine is the genetic targeting of patient segments, rather than individuals (i.e., they select very well molecularly-defined patient populations) to reduce the costs and size of clinical development and to increase commercial benefit since there is a pronounced treatment effect.

The general sentiment among speakers and the audience was that the science of personalized medicine is advancing faster than the healthcare infrastructure to support it. Cost is one of the major limitations. Life Technologies has reduced the cost of genome sequencing to thousands of dollars and is quickly approaching the $1000 genome. They recently acquired a semiconductor company, Ion Torrent, that may bring the cost of sequencing a genome on a chip to about $500. Still, standard gene tests today cost $1k-$2k per patient. Even when new tests come out, they can be slow to reach the clinic simply because it takes too much time to devise a reimbursement scheme with health insurance companies. IT infrastructure is another area for improvement in clinical and research areas. The need for clinical decision systems that collate the latest changes to clinical guidelines and molecular diagnostics was particularly emphasized by different speakers throughout the conference. Lastly, the conference speakers strongly recommended better molecular medicine education for clinicians, as well as better information dissemination to the general public regarding personalized medicine in order for this approach to succeed.

There were several recurring themes in the conference – precision medicine, collaboration, translational projects, and companion diagnostics. Translational projects and collaboration between industry and academia were mentioned in almost every talk, regardless of the speakers’ affiliation. The executive dean for research at Harvard Medical School decried research in isolation, saying “we need more ideas that don’t just sit around, but that are translated.” He and others went as far as to say that we will never make any progress without collaboration between government, industry, academia, regulators, and clinicians. One of the other most commonly discussed topics was companion diagnostics, the idea of developing drugs alongside a diagnostic test (or even post-market) that can be used to select patients for a particular drug. Companion diagnostics are increasingly being developed – 94% of pharma companies say they’re investing in personalized medicine, but only about 10% actually have compounds in late clinical development with companion diagnostics, meaning there will be more to come. FDA representatives said they will thus help companies integrate genomics into clinical development plans, and their companion diagnostics guidance is forthcoming next month.

Science is Great, but Sometimes Boring

I love science and engineering, which is why I’m in grad school for biomedical engineering. I have to admit, though, science can get boring sometimes. As awe-inspiring as science can be, scientists have some bad habits. As much as I try to avoid them, I’m guilty of having them too. I think the key to fixing them lies in a great 20-minute TED talk I saw recently. In this talk, Simon Sinek explains the difference between normal people/organizations and those who find themselves in positions of leadership. He frames his argument using the idea of the “golden circle”:



Taken from Yule Heibels blog at http://blogs.law.harvard.edu/yulelog

Taken from Yule Heibel's blog at http://blogs.law.harvard.edu/yulelog


Sinek explains that most individuals and organizations are stuck at the “What” or “How” level, and usually work from outside to inside the circle. Meanwhile, successful organizations like Apple and individuals like Martin Luther King, Jr. begin at the “Why” and work from inside to outside the circle.

The reason the latter group has so much success, Sinek says, is because people identify with the “Why”. He cleverly points out that MLK Jr. didn’t rally support by saying “I have a plan“, but rather by saying, “I have a dream“; Apple doesn’t say “we make great computers”, but rather, “we challenge the status quo and think differently about how we can live and be happy.” Such sentiments are things people can relate to more than a banal 12-step program for change or a list of technical specs for a computer.

I bring this up because in all the time I’ve spent in science and engineering, sometimes the field seems to get lost in the “What”. This is dangerous because that’s when things get pedantic. I’ve been to so many talks that describe some sophisticated new technology; to my chagrin, I often leave such talks still having the question, “so what? What can I do with this technology?” This is a common theme I’m seeing across labs I’ve worked in, science classes I’ve taken, and scientific talks I’ve attended. Additionally, some scientists are so focused on publishing papers. As a result, the applications of their work are mere afterthoughts.

Perhaps this is just the nature of research and development, as experiments often need to be run ad infinitum, slightly varying conditions each time for the most comprehensive results. Because of the volume of experiments performed, scientists get lost in the “What”. So when they talk about it to other people, they may omit their work’s context or applications simply out of habit, or even because they’ve begun to focus so much on making the experiment work instead of the original problem they were trying to solve. This is a bad habit that us scientists and engineers must drop, however, otherwise we risk becoming too pedantic! We should always strive to describe and think about our work in terms of the “Why” that drives it in the first place.

I’ve had conversations about this topic with my classmates before, and a lot of people feel this way. If you’re in science or engineering, what’s your experience with this? Do you think it’s hard for scientists to focus on the “Why” just because of the nature of science itself? Do we have the capacity to approach it differently?

Opportunity in a Bad Economy

The US and global economies are hungover from the last several years of risky-lending parties in the finance world. As a result, companies are cutting down on costs by downsizing staff or minimizing the scope of any projects that don’t directly generate profit (such as R&D or Marketing projects).

We all know that emotional decisions are often just plain stupid. Still, everybody is cutting these costs because of fear. I read a few articles recently that not only kill this fear with logic and solid evidence, but have really fired me up with optimism:

When times are good, everyone’s clamoring to have their voice heard. Today, however, your marketing dollar has more bang, largely because fewer people are advertising, selling, and getting the word out. It’s ripe for you to get out there, bang your drum, and perhaps even grab a couple of your competitors’ clients in the meanwhile. -Eric Karjaluoto

  • Hanging Tough from the New Yorker. This article nicely backs up the smashLAB article with historical evidence. Several times in the past, many companies have won market share by marketing harder in tough times, while the rest of the pack cut such spending. The discussion includes companies that found success during recessionary times, such as Kellogg’s, Chrysler, Texas Instruments, Kraft, and Apple. The author notes that in a downturn,

…it’s natural to focus on what you can control: minimizing losses and improving short-term results. And cutting spending is a good way of doing this; a major study, by the Strategic Planning Institute, of corporate behavior during the past thirty years found that reducing ad spending during recessions did improve companies’ return on capital. It also meant, though, that they grew less quickly in the years following recessions than more free-spending competitors did.

So, don’t stop beating your drum because it’s time to go at it even harder — you have a better chance of being heard now more than ever before. If you succeed in the short-term, you’ll also position yourself strongly for when the good times are rolling once again.

How to Make Sexy Websites

Not too long ago, I started making websites profesionally. After a lot of toiling, I discovered the key to making sexy websites: read, read, read! I always do my best work after having read many design blogs and articles, so I want to share the wealth with y’all (and thus hopefully make your learning curve more shallow).

While there is a trend of specialization developing in other industries, it seems that the web design and design industry favors those who have broader abilities (nevertheless, this is a debate they’re having in the financial world as well). For this reason, I try to keep constant tabs on the latest in general graphic design, branding, writing, and various programming technologies that are relevant to the web. Reflecting that blend, here are (IMHO) the most important websites that beginning web designers/web developers should thoroughly browse:

Greenies: For those just starting out

  • Web design from scratch – The BEST place to start if you’re just beginning to make professional websites. This site has a wide variety of topics, including the entire design process, graphics, and branding.
  • W3Schools – Check out their HTML and CSS tutorials in parallel with Web design from scratch (knowledge of HTML and CSS is super important because it gives you complete, pixel-by-pixel control over your designs). W3Schools’ tutorials give you really straightforward explanations and examples, and beat the pants off of reading huge books since they convey their information concisely.

The (barely?) Initiated: beyond the basics

Graphics Creation

  • You Suck at Photoshop – You need some graphics skills to make sexy websites, and Photoshop is usually the weapon of choice for graphics work. This link is geared towards beginners (and is hilarious).
  • PSDTUTS – More advanced tutorials for when you stop sucking at Photoshop ;)

Logo Blogs

Branding Blogs

Design

  • CSS Remix – For inspiration from CSS-based designs
  • Toxel – General creative design inspiration (covers creativity in the virtual and physical realms)
  • Design Meltdown – A site focusing on web design
  • Some designers include description and rationale behind projects in their portfolios (like Mark Boulton). These can be pretty useful to go through.

General

  • A List Apart – A very popular website “for people who make websites,” with an emphasis on code.
  • NETTUTS – From the same people who brought you PSDTUTS, these guys give you a lot of tips on more advanced things you can do with HTML, CSS, etc.
  • Freelance Switch – About the business of being a freelance designer, writer, illustrator, farmer, or whateverer.

How to keep up without perpetually having 20 Firefox tabs open

These resources are by no means an exhaustive list, but are certainly good starting points. If you haven’t set up an RSS feed reader yet, you should strongly consider it – it’s the easiest way to be in the loop on all of these websites (I use Google Reader). Of course, there’s way too much good stuff on the web about making websites, so BEWARE: you may become info-whelmed.

If you know of some good sites that I’ve left off my list, drop a comment and help us all!

Adjusting to Globalization: Why is the US Falling Behind?

In the New York Times article, “It’s a Flat World, After All,” Thomas L. Friedman writes:

“These are some of the reasons that Bill Gates, the Microsoft chairman, warned the governors’ conference in a Feb. 26 speech that American high-school education is “obsolete.” As Gates put it: “When I compare our high schools to what I see when I’m traveling abroad, I am terrified for our work force of tomorrow. In math and science, our fourth graders are among the top students in the world. By eighth grade, they’re in the middle of the pack. By 12th grade, U.S. students are scoring near the bottom of all industrialized nations. . . . The percentage of a population with a college degree is important, but so are sheer numbers. In 2001, India graduated almost a million more students from college than the United States did. China graduates twice as many students with bachelor’s degrees as the U.S., and they have six times as many graduates majoring in engineering. In the international competition to have the biggest and best supply of knowledge workers, America is falling behind.

“We need to get going immediately. It takes 15 years to train a good engineer, because, ladies and gentlemen, this really is rocket science. So parents, throw away the Game Boy, turn off the television and get your kids to work. There is no sugar-coating this: in a flat world, every individual is going to have to run a little faster if he or she wants to advance his or her standard of living.”  

While I agree with Friedman about the world’s flatness and the danger of America becoming mediocre, I disagree with his message that we must work harder. Don’t get me wrong — I’m not afraid of hard work. My objection lies in the fact that Mr. Friedman’s recommendation reflects our society’s short-term mentality that working “harder” (by studying for more hours, sleeping less, etc.) will get us ahead; what he critically neglects to discuss is the consequences of “working harder”: the increased stress and drastic decrease of quality of life that is becoming a reality for today’s students.Instead of changing how hard we work, we must totally overhaul our education system so that it encourages interdisciplinary approaches to solving problems, as well as creative thought and reasoning. Right now, Bill Gates is right — science and math education is obsolete in this country. These subjects need to be taught in a more practical manner if this country wants to increase production of scientists and engineers! The main problem with science education today is that it leaves kids wondering, “so what? why should I care?” (I certainly felt this way throughout much of the coursework for my chemistry degree at Boston University.) It’s pedantic to the point of disgust. School should be just as fun as picking up the Game Boy, so fixing the education system will automatically draw kids away from playing games excessively.

Science in high schools and undergraduate universities is no longer empirical. It is textbook-based. Even in the laboratory for science classes, there is little room for tinkering and scientific adventure because everything is dictated by a stifling lab manual procedure that doesn’t communicate the importance of the particular experiment being conducted. The exception is independent research projects, which only a fraction of science students actually pursue; and that too, you usually start it late in your undergraduate career. Before many science students even reach that point, they leave because they were not given any opportunity to apply what they learned in class to a real scientific problem.

Additionally, the humanities cannot be forgotten — as the world becomes flat, appreciation for humankind is vaporizing. It’s okay that we need to work harder to produce more scientists and engineers to compete in the world, but not at the cost of our human element. Scientists and engineers are notorious for their apathy towards language, literature, and the rest of that “fluff.” What they miss is the fact that the humanities help you learn how to interact and communicate with your society — a skill that is important regardless of your career path. Not only that, but you develop an appreciation for people as individuals (in practical terms, your reasoning and ability to analyze a person’s character are strengthened). We have to get away from our divisions of study into individual subjects, and present an interdisciplinary approach to learning science — perhaps pairing biology with poetry, or engineering with music. These approaches will not only increase the retention rate of science and engineering majors, and allow students to enjoy science more, but will also allow them to appreciate science within the broader human context from which it originated. THAT will help interest more into science and engineering; not throwing away the game boy, or “working harder.” If science students are going to be spending so much time to learn all that is necessary to become scientists, their educators need to make it worth their efforts and sacrifices.

Adapting to a flattened, globalized world is a bigger problem that transcends the lack of parental guidance: the root lies in a flawed and impractical education system.